{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T03:41:27Z","timestamp":1790394087112,"version":"4.1.0"},"reference-count":16,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Interventions"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>\n              Patients with ST-segment\u2013elevation myocardial infarction but no coronary microvascular injury are at low risk of early cardiovascular complications (ECC). We aim to assess whether nonhyperemic angiography-derived index of microcirculatory resistance (NH-IMR\n              <jats:sub>angio<\/jats:sub>\n              ) could be a user-friendly tool to identify patients at low risk of ECC, potentially candidates for expedited care pathway and early hospital discharge.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>\n              Retrospective analysis of 2 independent, international, prospective, observational cohorts included 568 patients with ST-segment\u2013elevation myocardial infarction. NH-IMR\n              <jats:sub>angio<\/jats:sub>\n              was calculated based on standard coronary angiographic views with 3-dimensional-modeling and computational analysis of the coronary flow.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>\n              Overall, ECC (a composite of cardiovascular death, cardiogenic shock, acute heart failure, life-threatening arrhythmias, resuscitated cardiac arrest, left ventricular thrombus, post-ST-segment\u2013elevation myocardial infarction mechanical complications, and rehospitalization for acute heart failure or acute myocardial infarction at 30 days follow-up), occurred in 54 (9.3%) patients. NH-IMR\n              <jats:sub>angio<\/jats:sub>\n              was significantly correlated with pressure\/thermodilution-based index of microcirculatory resistance (r=0.607;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              &lt;0.0001) and demonstrated good accuracy in predicting ECC (area under the curve, 0.766 [95% CI, 0.706\u20130.827];\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              &lt;0.0001). Importantly, ECC occurred more frequently in patients with NH-IMR\n              <jats:sub>angio<\/jats:sub>\n              \u226540 units (18.1% versus 1.4%;\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              &lt;0.0001). At multivariable analysis, NH-IMR\n              <jats:sub>angio<\/jats:sub>\n              provided incremental prognostic value to conventional clinical, angiographic, and echocardiographic features (adjusted-odds ratio, 14.861 [95% CI, 5.177\u201342.661];\n              <jats:italic toggle=\"yes\">P<\/jats:italic>\n              &lt;0.0001). NH-IMR\n              <jats:sub>angio<\/jats:sub>\n              &lt;40 units showed an excellent negative predictive value (98.6%) in ruling out ECC. Discharging patients with NH-IMR\n              <jats:sub>angio<\/jats:sub>\n              &lt;40 units at 48 hours after admission would reduce the total in-hospital stay by 943 days (median 2 [1\u20134] days per patient).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>\n              NH-IMR\n              <jats:sub>angio<\/jats:sub>\n              is a valuable risk-stratification tool in patients with ST-segment\u2013elevation myocardial infarction. NH-IMR\n              <jats:sub>angio<\/jats:sub>\n              guided strategies to early discharge may contribute to safely shorten hospital stay, optimizing resources utilization.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circinterventions.123.013556","type":"journal-article","created":{"date-parts":[[2024,2,20]],"date-time":"2024-02-20T10:10:33Z","timestamp":1708423833000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":18,"title":["Angiography-Derived Index of Microcirculatory Resistance to Define the Risk of Early Discharge in STEMI"],"prefix":"10.1161","volume":"17","author":[{"given":"Roberto","family":"Scarsini","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Medicine, University of Verona, Italy (R.S., F.D.M., L.P., S.A., S.S., A.C., C.B., G.P., D.T., F.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafail A.","family":"Kotronias","sequence":"additional","affiliation":[{"name":"Oxford Heart Centre, Oxford University Hospitals NHS Trust, United Kingdom (R.A.K., S.B., F.M., K.M.C., A.P.B., G.L.D.M.)."},{"name":"Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, United Kingdom (R.A.K., S.B., F.M., K.M.C., A.P.B., G.L.D.M.)."},{"name":"National Institute for Health Research, Oxford Biomedical Research Centre, United Kingdom (R.A.K., S.B., F.M., K.M.C., A.P.B., G.L.D.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Della Mora","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, University of Verona, Italy (R.S., F.D.M., L.P., S.A., S.S., A.C., C.B., G.P., D.T., F.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5058-8218","authenticated-orcid":true,"given":"Leonardo","family":"Portolan","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, University of Verona, Italy (R.S., F.D.M., L.P., S.A., S.S., A.C., C.B., G.P., D.T., F.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-6115-5822","authenticated-orcid":true,"given":"Stefano","family":"Andreaggi","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, University of Verona, Italy (R.S., F.D.M., L.P., S.A., S.S., A.C., C.B., G.P., D.T., F.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9669-4278","authenticated-orcid":true,"given":"Stefano","family":"Benenati","sequence":"additional","affiliation":[{"name":"Oxford Heart Centre, Oxford University Hospitals NHS Trust, United Kingdom (R.A.K., S.B., F.M., K.M.C., A.P.B., G.L.D.M.)."},{"name":"Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, United Kingdom (R.A.K., S.B., F.M., K.M.C., A.P.B., G.L.D.M.)."},{"name":"National Institute for Health Research, Oxford Biomedical Research Centre, United Kingdom (R.A.K., S.B., F.M., K.M.C., A.P.B., G.L.D.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8776-6647","authenticated-orcid":true,"given":"Federico","family":"Marin","sequence":"additional","affiliation":[{"name":"Oxford Heart Centre, Oxford University Hospitals NHS Trust, United Kingdom (R.A.K., S.B., F.M., K.M.C., A.P.B., G.L.D.M.)."},{"name":"Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, United Kingdom (R.A.K., S.B., F.M., K.M.C., A.P.B., G.L.D.M.)."},{"name":"National Institute for Health Research, Oxford Biomedical Research Centre, United Kingdom 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L.P., S.A., S.S., A.C., C.B., G.P., D.T., F.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2770-8231","authenticated-orcid":true,"given":"Gabriele","family":"Pesarini","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, University of Verona, Italy (R.S., F.D.M., L.P., S.A., S.S., A.C., C.B., G.P., D.T., F.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domenico","family":"Tavella","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, University of Verona, Italy (R.S., F.D.M., L.P., S.A., S.S., A.C., C.B., G.P., D.T., F.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith M.","family":"Channon","sequence":"additional","affiliation":[{"name":"Oxford Heart Centre, Oxford University Hospitals NHS Trust, United Kingdom (R.A.K., S.B., F.M., K.M.C., A.P.B., G.L.D.M.)."},{"name":"Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, United Kingdom (R.A.K., S.B., F.M., K.M.C., A.P.B., G.L.D.M.)."},{"name":"National Institute for Health Research, Oxford Biomedical Research Centre, United Kingdom (R.A.K., S.B., F.M., K.M.C., A.P.B., G.L.D.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5100-0471","authenticated-orcid":true,"given":"Hector M.","family":"Garcia Garcia","sequence":"additional","affiliation":[{"name":"Interventional Cardiology, MedStar Washington Hospital Centre (H.M.G.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6662-0304","authenticated-orcid":true,"given":"Flavio","family":"Ribichini","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, University of Verona, Italy (R.S., F.D.M., L.P., S.A., S.S., A.C., C.B., G.P., D.T., 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